IDENTIFICATION AND TREATMENT OF CHILDHOOD LANGUAGE IMPAIRMENT INMULTICULTURAL POPULATIONS
NIH GUIDE, Volume 21, Number 38, October 23, 1992
PA NUMBER: PA-93-011
P.T. 34, AA
Keywords:
Language Acquisition & Development
Learning Disabled Education
National Institute on Deafness and Other Communication Disorders
PURPOSE
Many children who are members of multicultural populations, such as
African-, Asian-, and Hispanic-Americans, are often incorrectly
identified as language impaired because culturally appropriate
language assessment instruments are largely unavailable. In
addition, those multicultural children with genuine language
disorders in need of remediation may go unrecognized. The need for
culturally sensitive assessment tools to evaluate the language of
multicultural children has long been recognized, yet progress in this
area is lacking. The National Institute on Deafness and Other
Communication Disorders (NIDCD) encourages applications to develop or
expand upon currently available diagnostic, as well as treatment
procedures, for language-impaired children from multicultural
environments.
HEALTHY PEOPLE 2000
The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas. This Program
Announcement (PA), Identification and Treatment of Childhood Language
Impairment in Multicultural Populations, is related to the priority
areas of diabetes and chronic disabling conditions and special
population objectives. Potential applicants may obtain a copy of
"Healthy People 2000" (Full Report: Stock No. 017-001-11474-0 or
Summary Report: Stock No. 017-001-11473-1) through the
Superintendent of Documents, Government Printing Office, Washington,
DC 20402-9325 (telephone 202-783-3238).
ELIGIBILITY REQUIREMENTS
Applications may be submitted by domestic and foreign, for-profit and
non-profit organizations, public and private, such as universities,
colleges, hospitals, laboratories, units of State and local
governments, and eligible agencies of the Federal government.
Applications from minority individuals and women are encouraged.
Foreign institutions are not eligible for the First Independent
Research Support and Transition (FIRST) (R29) Award or the Small
Business Innovation Research (SBIR) (R43) Awards.
MECHANISM OF SUPPORT
The support mechanisms for grants in this area will be the
investigator-initiated research grant (R01), the FIRST (R29) award,
and the SBIR (R43) award.
RESEARCH OBJECTIVES
The United States has a culturally diverse population, with the rate
of increase in the minority population accelerating in recent years.
According to recent census figures, 23 million people over the age of
five speak a language other than Standard English in the home.
Almost half of these individuals reportedly do not speak English at
all or do not speak it proficiently. A disproportionate number of
children from these environments are identified as language impaired.
Dialectal varieties of English are not considered a disorder or a
pathological form of speech or language, although dialect speakers
may have language disorders within the dialect. To make accurate
diagnoses of language impairment, it is important to distinguish
between those aspects of linguistic variation that represent a
difference or diversity from those that represent a disorder.
In recent years, researchers and clinicians have questioned the
validity of most speech and language assessment measures for
multicultural children. Because of these children's diverse
cultural, economic, and linguistic backgrounds, these procedures and
instruments, by their content and design, often discriminate against
children whose native language is not Standard English. Thus, high
proportions of these children are incorrectly identified as language
disordered and are subsequently placed into special education or
communication disorders programs. Appropriate assessment of language
skills and proper academic placement are critical if multicultural
children are to achieve their potential. Nonetheless, few
standardized tests address the issues of cultural and linguistic
diversity in their construction. In addition, most available
instruments have not been standardized on children from different
cultural, economic, or linguistic backgrounds. These problems make
appropriate diagnosis and treatment difficult.
Examples of issues to be addressed in applications submitted in
response to this PA include, but are not limited to, the following:
Language Impairment
o Definition and characteristics of impaired language in specific
cultures at varying ages (including phonology, syntax, semantics,
pragmatics)
o Bilingual proficiency and language disorders, including factors
such as type of exposure to English, age of acquisition of English,
and code switching
Assessment
o Means of differentiating between language differences and
disorders across cultural groups (that is, procedures for
differentiating disordered language from normal language differences
due to a nonstandard dialect of English, or to the acquisition of
English as a second language)
o Development of evaluative measures that are culturally fair, or
modifications/adaptations of existing measures that would make them
more culturally sensitive
o Establishment of cultural norms for determining presence or
absence of communication disorders
o Development of language sampling procedures or observational
techniques that are valid within specific cultures
o Differing assessment models (e.g., natural context, questionnaire)
and their validity
o Factors that influence assessment process, such as the effect of
ethnic group membership of the examiner on test scores; the test
environment; examiner's fluency in the child's language
Treatment
o Factors that impede efficacy of treatment in the clinical
management of children from multicultural environments
o Impact of cognitive factors, interpersonal and ecological factors,
preferred learning style, and cultural systems of belief on response
to treatment
o Development of effective, innovative intervention strategies or
models of service delivery, and frameworks for treatment within
specific cultures
o Factors related to effective language intervention, including
effects of using only the first language, both the first and second
languages, or English-only treatment; language skills of
speech-language pathologist in both languages; effects of
communication events within clinical setting on the level of
linguistic performance
STUDY POPULATIONS
SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING IMPLEMENTATION OF NIH
POLICIES CONCERNING INCLUSION OF WOMEN AND MINORITIES IN CLINICAL
RESEARCH STUDY POPULATIONS
NIH policy is that applicants for NIH clinical research grants and
cooperative agreements are required to include minorities and women
in study populations so that research findings can be of benefit to
all persons at risk of the disease, disorder or condition under
study; special emphasis must be placed on the need for inclusion of
minorities and women in studies of diseases, disorders and conditions
which disproportionately affect them. This policy is intended to
apply to males and females of all ages. If women or minorities are
excluded or inadequately represented in clinical research,
particularly in proposed population-based studies, a clear compelling
rationale must be provided.
The composition of the proposed study population must be described in
terms of gender and racial/ethnic group. In addition, gender and
racial/ethnic issues must be addressed in developing a research
design and sample size appropriate for the scientific objectives of
the study. This information must be included in the form PHS 398 in
Sections 1-4 of the Research Plan AND summarized in Section 5, Human
Subjects. Applicants are urged to assess carefully the feasibility
of including the broadest possible representation of minority groups.
However, the NIH recognizes that it may not be feasible or
appropriate in all research projects to include representation of the
full array of United States racial/ethnic minority populations (i.e.,
Native Americans [including American Indians or Alaskan Natives],
Asian/Pacific Islanders,African-Americans, Hispanics). The rationale
for studies on single minority population groups should be provided.
For the purpose of this policy, clinical research is defined as human
biomedical and behavioral studies of etiology, epidemiology,
prevention (and preventive strategies), diagnosis, or treatment of
diseases, disorders or conditions, including but not limited to
clinical trials.
The usual NIH policies concerning research on human subjects also
apply. Basic research or clinical studies in which human tissues
cannot be identified or linked to individuals are excluded. However,
every effort should be made to include human tissues from women and
racial/ethnic minorities when it is important to apply the results of
the study broadly, and this should be addressed by applicants.
For foreign awards, the policy on inclusion of women applies fully;
since the definition of minority differs in other countries, the
applicant must discuss the relevance of research involving foreign
population groups to the United States' populations, including
minorities.
If the required information is not contained within the application,
the application will be returned.
Peer reviewers will address specifically whether the research plan in
the application conforms to these policies. If the representation of
women or minorities in a study design is inadequate to answer the
scientific question(s) addressed AND the justification for the
selected study population is inadequate, it will be considered a
scientific weakness or deficiency in the study design and reflected
in assigning the priority score to the application.
All applications for clinical research submitted to the NIH are
required to address these policies. NIH funding components will not
award grants or cooperative agreements that do not comply with these
policies.
APPLICATION PROCEDURES
Applications for R01 and FIRST (R29) awards are to be submitted on
the grant application form PHS 398 (rev. 9/91) and will be accepted
at the standard application deadlines as indicated in the application
kit. Applications for SBIR (R43) awards are to be submitted on the
grant application form PHS 6246-1 (rev. 1/92) and will be accepted at
the SBIR application deadlines as indicated in the application kit.
These kits are available from most institutional offices of sponsored
research, the NIDCD Program Administrator cited below, and the Office
of Grants Inquiries, Division of Research Grants, National Institutes
of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone
(301) 496-7441. The title and number of the announcement must be
typed in Section 2a on the face page of the application. FIRST (R29)
award applications must include at least three sealed letters of
reference attached to the face page of the original application.
First (R29) award applications submitted without the required number
of reference letters will be considered incomplete and will be
returned to the applicant without review.
The completed original application and five legible copies of the PHS
398, or two copies of the PHS 6246-1, must be sent or delivered to:
Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD 20892**
REVIEW CONSIDERATIONS
Applications will be reviewed for scientific and technical merit by
an appropriate Initial Review Group within the Division of Research
Grants, NIH, in accordance with the standard NIH peer review
procedures. Following scientific-technical review, the applications
will receive a second-level review by the appropriate National
Advisory Council.
AWARD CRITERIA
Applications will compete for available funds with all other
applications. The following will be considered in when funding
decisions:
o Quality of the proposed project as determined by peer review
o Availability of funds
o Program balance among research areas of the announcement
INQUIRIES
Written and telephone inquiries concerning this PA are encouraged.
The opportunity to clarify any issues or questions from potential
applicants is welcome.
Direct inquiries regarding programmatic issues to:
Judith A. Cooper, Ph.D.
Deputy Director, Division of Communication Sciences and Disorders
National Institute on Deafness and Other Communication Disorders
Executive Plaza South, Room 400-B
6120 Executive Boulevard
Rockville, MD 20892
Telephone: (301) 496-5061
FAX: (301) 402-6251
Direct inquiries regarding fiscal matters to:
Sharon Hunt
Grants Management Officer
National Institute on Deafness and Other Communication Disorders
Executive Plaza South, Room 400-B
6120 Executive Boulevard
Rockville, MD 20892
Telephone: (301) 402-0909
AUTHORITY AND REGULATIONS
This program is described in the Catalog of Federal Domestic
Assistance No. 93.173. Awards are made under authorization of the
Public Health Service Act, Title IV, Part A (Public Law 78-410, as
amended by Public Law 99-158, 42 USC 241 and 285) and administered
under PHS grants policies and Federal Regulations 42 CFR 52 and 45
CFR Part 74. This program is not subject to the intergovernmental
review requirements of Executive Order 12372 or Health Systems Agency
review.
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